Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer

Jan 10, 2020Journal of psychopharmacology (Oxford, England)

Long-term effects of psilocybin therapy on mental and emotional distress in patients with life-threatening cancer

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Abstract

At a 4.5-year follow-up, 60-80% of participants continued to show clinically significant antidepressant or anxiolytic responses after psilocybin-assisted psychotherapy.

Reductions in anxiety, depression, hopelessness, demoralization, and death anxiety were sustained at both follow-up points.
Within-group effect sizes were large, indicating substantial improvements in mental health outcomes.
A majority of participants (71-100%) reported positive life changes attributed to their psilocybin-assisted therapy experience.
Participants rated their psilocybin experience among the most meaningful and spiritually significant of their lives.
Findings suggest that psilocybin-assisted psychotherapy may promote long-term relief from cancer-related psychiatric distress.

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BACKGROUND: A recently published randomized controlled trial compared single-dose psilocybin with single-dose niacin in conjunction with psychotherapy in participants with cancer-related psychiatric distress. Results suggested that psilocybin-assisted psychotherapy facilitated improvements in psychiatric and existential distress, quality of life, and spiritual well-being up to seven weeks prior to the crossover. At the 6.5-month follow-up, after the crossover, 60-80% of participants continued to meet criteria for clinically significant antidepressant or anxiolytic responses.

METHODS: The present study is a long-term within-subjects follow-up analysis of self-reported symptomatology involving a subset of participants that completed the parent trial. All 16 participants who were still alive were contacted, and 15 participants agreed to participate at an average of 3.2 and 4.5 years following psilocybin administration.

RESULTS: Reductions in anxiety, depression, hopelessness, demoralization, and death anxiety were sustained at the first and second follow-ups. Within-group effect sizes were large. At the second (4.5 year) follow-up approximately 60-80% of participants met criteria for clinically significant antidepressant or anxiolytic responses. Participants overwhelmingly (71-100%) attributed positive life changes to the psilocybin-assisted therapy experience and rated it among the most personally meaningful and spiritually significant experiences of their lives.

CONCLUSION: These findings suggest that psilocybin-assisted psychotherapy holds promise in promoting long-term relief from cancer-related psychiatric distress. Limited conclusions, however, can be drawn regarding the efficacy of this therapy due to the crossover design of the parent study. Nonetheless, the present study adds to the emerging literature base suggesting that psilocybin-facilitated therapy may enhance the psychological, emotional, and spiritual well-being of patients with life-threatening cancer.

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Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer

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